As a menopause care provider, I have lots of conversations with women about sex. I’ve heard confirmation that our motivations to have sex change with our situations. What motivates us when we’re young and single is very different from what motivates us when we’re older and in longstanding relationships, or older and single.

So when we suffer from lack of desire—are we missing the sort of drive we had when we were teenagers? Or is it possible we just haven’t found a new motivation for sex? The more we learn from women, the more it seems that for us sex doesn’t always begin with lust, but instead starts in our hearts and minds. We engage in our heads first, decide to have sex, and then with enough mental and emotional stimulation, our genitals respond. The older we grow, the more this is true. Age and maturity bring a new game into the bedroom.

For us, having sex is less an urge than a decision, one we can make and then act upon. When we decide to say yes instead of no, decide to schedule sex instead of waiting (perhaps for a very long time…) for our body to spontaneously light on fire, decide to engage with media or methods that will put us in the mood rather than wait for romantic moments to happen along, we’re using our heads to keep sex in our relationships.

Deciding to be intimate unlocks the pleasure. And the more sex we decide to have, the more sex we will feel like having. That’s the secret to regular bonding.

Why just decide to do it? This much we know:

Sex leads to a longer life.

Sex, like all exercise, helps protect us against heart attack and possibly stroke.

Hormones released during sex may decrease the risk of breast cancer and prostate cancer.

That last point is what I hear most often in my practice: Women want to keep or already miss the intimacy with their partners that mutually satisfying sex communicates. While they also miss the feelings of power and wellbeing that sex gives them, it’s the loss of connection that impels them to take action.

And you can take action, too. We don’t need to wait around for “desire” to lead to thoroughly satisfying sex. We can use our heads.